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Screening for transcatheter mitral valve replacement: a decision tree algorithm

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Screening for transcatheter mitral valve replacement: a decision tree algorithm. / Ludwig, Sebastian; Ruebsamen, Nicole; Deuschl, Florian; Schofer, Niklas; Kalbacher, Daniel; Schaefer, Andreas; Koell, Benedikt; Westermann, Dirk; Reichenspurner, Hermann; Blankenberg, Stefan; Schäfer, Ulrich; Conradi, Lenard; Lubos, Edith.

In: EUROINTERVENTION, Vol. 16, No. 3, 25.06.2020, p. 251-258.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Ludwig, S, Ruebsamen, N, Deuschl, F, Schofer, N, Kalbacher, D, Schaefer, A, Koell, B, Westermann, D, Reichenspurner, H, Blankenberg, S, Schäfer, U, Conradi, L & Lubos, E 2020, 'Screening for transcatheter mitral valve replacement: a decision tree algorithm', EUROINTERVENTION, vol. 16, no. 3, pp. 251-258. https://doi.org/10.4244/EIJ-D-19-01051

APA

Ludwig, S., Ruebsamen, N., Deuschl, F., Schofer, N., Kalbacher, D., Schaefer, A., Koell, B., Westermann, D., Reichenspurner, H., Blankenberg, S., Schäfer, U., Conradi, L., & Lubos, E. (2020). Screening for transcatheter mitral valve replacement: a decision tree algorithm. EUROINTERVENTION, 16(3), 251-258. https://doi.org/10.4244/EIJ-D-19-01051

Vancouver

Ludwig S, Ruebsamen N, Deuschl F, Schofer N, Kalbacher D, Schaefer A et al. Screening for transcatheter mitral valve replacement: a decision tree algorithm. EUROINTERVENTION. 2020 Jun 25;16(3):251-258. https://doi.org/10.4244/EIJ-D-19-01051

Bibtex

@article{ed16274e1f9c421ba064905a7d343006,
title = "Screening for transcatheter mitral valve replacement: a decision tree algorithm",
abstract = "AIMS: The high frequency of screening failure for anatomical reasons in patients with severe mitral valve regurgitation (MR) is a limiting factor in the screening process for transcatheter mitral valve replacement (TMVR). However, data on optimal patient selection are scarce. The present study aimed to develop a screening algorithm based on TMVR screening data.METHODS AND RESULTS: A total of 195 screenings for six different TMVR devices were performed in 94 high-risk patients with severe MR. We compared baseline echocardiographic and multislice computed tomography (MSCT) parameters between the subgroups of patients accepted (N=33) and rejected for TMVR (N=61). Reasons for screening failure were assessed, and a decision tree algorithm was statistically derived. Reasons for screening failure were small LV dimensions (30.6%), small (7.5%) or large (22.5%) annular size, potential risk of LVOT obstruction (22.0%) or mitral annulus calcification (15.6%). A four-step decision tree algorithm to assess TMVR eligibility was developed resulting in an AUC of 0.80 (95% CI: 0.71, 0.89, p<0.0001).CONCLUSIONS: This study presents the first screening algorithm to assess anatomical eligibility for TMVR in patients with severe MR, based on simple MSCT criteria. Given the high rate of TMVR screening failure, this algorithm may facilitate the identification of potential TMVR candidates.",
keywords = "Algorithms, Cardiac Catheterization/methods, Decision Trees, Heart Valve Prosthesis Implantation/methods, Humans, Mitral Valve, Mitral Valve Insufficiency/surgery, Treatment Outcome",
author = "Sebastian Ludwig and Nicole Ruebsamen and Florian Deuschl and Niklas Schofer and Daniel Kalbacher and Andreas Schaefer and Benedikt Koell and Dirk Westermann and Hermann Reichenspurner and Stefan Blankenberg and Ulrich Sch{\"a}fer and Lenard Conradi and Edith Lubos",
year = "2020",
month = jun,
day = "25",
doi = "10.4244/EIJ-D-19-01051",
language = "English",
volume = "16",
pages = "251--258",
journal = "EUROINTERVENTION",
issn = "1774-024X",
publisher = "EUROPA EDITION",
number = "3",

}

RIS

TY - JOUR

T1 - Screening for transcatheter mitral valve replacement: a decision tree algorithm

AU - Ludwig, Sebastian

AU - Ruebsamen, Nicole

AU - Deuschl, Florian

AU - Schofer, Niklas

AU - Kalbacher, Daniel

AU - Schaefer, Andreas

AU - Koell, Benedikt

AU - Westermann, Dirk

AU - Reichenspurner, Hermann

AU - Blankenberg, Stefan

AU - Schäfer, Ulrich

AU - Conradi, Lenard

AU - Lubos, Edith

PY - 2020/6/25

Y1 - 2020/6/25

N2 - AIMS: The high frequency of screening failure for anatomical reasons in patients with severe mitral valve regurgitation (MR) is a limiting factor in the screening process for transcatheter mitral valve replacement (TMVR). However, data on optimal patient selection are scarce. The present study aimed to develop a screening algorithm based on TMVR screening data.METHODS AND RESULTS: A total of 195 screenings for six different TMVR devices were performed in 94 high-risk patients with severe MR. We compared baseline echocardiographic and multislice computed tomography (MSCT) parameters between the subgroups of patients accepted (N=33) and rejected for TMVR (N=61). Reasons for screening failure were assessed, and a decision tree algorithm was statistically derived. Reasons for screening failure were small LV dimensions (30.6%), small (7.5%) or large (22.5%) annular size, potential risk of LVOT obstruction (22.0%) or mitral annulus calcification (15.6%). A four-step decision tree algorithm to assess TMVR eligibility was developed resulting in an AUC of 0.80 (95% CI: 0.71, 0.89, p<0.0001).CONCLUSIONS: This study presents the first screening algorithm to assess anatomical eligibility for TMVR in patients with severe MR, based on simple MSCT criteria. Given the high rate of TMVR screening failure, this algorithm may facilitate the identification of potential TMVR candidates.

AB - AIMS: The high frequency of screening failure for anatomical reasons in patients with severe mitral valve regurgitation (MR) is a limiting factor in the screening process for transcatheter mitral valve replacement (TMVR). However, data on optimal patient selection are scarce. The present study aimed to develop a screening algorithm based on TMVR screening data.METHODS AND RESULTS: A total of 195 screenings for six different TMVR devices were performed in 94 high-risk patients with severe MR. We compared baseline echocardiographic and multislice computed tomography (MSCT) parameters between the subgroups of patients accepted (N=33) and rejected for TMVR (N=61). Reasons for screening failure were assessed, and a decision tree algorithm was statistically derived. Reasons for screening failure were small LV dimensions (30.6%), small (7.5%) or large (22.5%) annular size, potential risk of LVOT obstruction (22.0%) or mitral annulus calcification (15.6%). A four-step decision tree algorithm to assess TMVR eligibility was developed resulting in an AUC of 0.80 (95% CI: 0.71, 0.89, p<0.0001).CONCLUSIONS: This study presents the first screening algorithm to assess anatomical eligibility for TMVR in patients with severe MR, based on simple MSCT criteria. Given the high rate of TMVR screening failure, this algorithm may facilitate the identification of potential TMVR candidates.

KW - Algorithms

KW - Cardiac Catheterization/methods

KW - Decision Trees

KW - Heart Valve Prosthesis Implantation/methods

KW - Humans

KW - Mitral Valve

KW - Mitral Valve Insufficiency/surgery

KW - Treatment Outcome

U2 - 10.4244/EIJ-D-19-01051

DO - 10.4244/EIJ-D-19-01051

M3 - SCORING: Journal article

C2 - 32287036

VL - 16

SP - 251

EP - 258

JO - EUROINTERVENTION

JF - EUROINTERVENTION

SN - 1774-024X

IS - 3

ER -